Estimate of the criterion for R0 resection in primary hepatocellular carcinoma        WU Li-qun, QIU Fa-bo, ZHANG Shun, et al. Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University, Qingdao 266003, China
Corresponding author：WU Li-qun, E-mail：wulq5810@126.com
Abstract    Objective    To estimate the criterion for R0 resection of primary hepatocellular carcinoma (HCC). Methods The clinical data of 406 cases of primary HCC underwent hepatectomy from January 1998 to December 2007 in Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College Qingdao University were analyzed retrospectively. The relationships between the clinical, operative and pathologic factors were analyzed. Results    The factors which the median recurrence-free survival months were smaller than 6 months were considered non-R0 resection, included the vascular invasion, palliation resection, cutting edge pathologic residual tumor, lymph notes metastasis, serum AFP level continuing higher after operation or / and positive TACE (tumor dyeing on TACE within 1 month and a deposit of lipiodol on CT scan). There were 315 cases of R0 resection. Their recurrence-free survival was 84%, 67%, 42% and 30% (1, 2, 5 and 10 year) and overall survival was 97%, 86%, 56% and 35%. In 91 cases of non-R0 resection, the recurrence-free survival was 22%, 11% and 3% (1, 2 and 5 year) and overall survival was 48%, 26% and 10%. Conclusion    The R0 criterion for HCC resection contains the vascular invasion, palliation resection, cutting edge pathologic residual tumor, lymph notes metastasis, serum AFP level continuing higher after resection or / and tumor dyeing on TACE within 1 month.